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Individual

DR. ZANYAR DARVISHI SR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
10535 NE GLISAN ST STE 301, PORTLAND, OR 97220-4077
(503) 444-2824
Mailing address
10535 NE GLISAN ST STE 301, PORTLAND, OR 97220-4077
(503) 444-2824

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D11343
OR
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
D11343
OR
390200000X
Student in an Organized Health Care Education/Training Program
OR

Other

Enumeration date
04/14/2020
Last updated
06/13/2022
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